Introduction: Seizures are symptoms of abnormal brain function and occur due to diverse etiology. The aim of the study was to evaluate the diagnostic efficacy of MRI of the brain in children with first onset seizures and to compare the diagnostic yields of MRI and EEG individually and in combination. Material and methods: The study consists of One hundred and twelve patients (112) with an age range from 5 days to 18 years with first onset seizures who underwent MR imaging and EEG. Sensitivity was calculated to both MRI and EEG separately and together. Chi square test was applied. 95% confidence interval of sensitivity was calculated. Epi info version 3 was used for statistical calculations. Results: Out of 112 cases, 69% were male and 31% female. Out of 112 cases, 50 cases (45%) showed... epileptiform abnormalities on MRI, most common being infection and inflammation (26%) followed by HIE sequelae (24%). Out of 112 cases, 40 (36%) showed focal epileptiform abnormalities on EEG. Out of 112 cases, 15 (13%) were both MRI positive and EEG positive, 37(33%) were both MRI and EEG negative, 35(31%) were only MRI positive and 25(22%) were only EEG positive. Conclusion: MRI and EEG are the methods of choice for evaluation of patients with seizure, MRI can identify structural brain lesions, that can serve as epileptogenic foci, that might be surgically resectable if the patient becomes refractory to medical treatment.